Keith’s GoutPal Story 2020 Forums Please Help My Gout! Gout in toe is ridiculously painful!

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    I have now been taking 300 mg of Alopurinol daily for close to a month now.  Just last week I had my uric acid levels tested and got the result back last Thursday.  My level was 5.7 which I understand is pretty good.  While starting the Alopurinol I expected to feel some discomfort in some joints as the drug does its work, but I didn’t expect a full-on attack.  This past Sunday I awoke with a very swollen, red and painful middle toe.  The attack is still going strong today, barely allowing me to wear a shoe.  Is this normal?  A full attack with a uric acid level of 5.7 and almost four weeks on Alopurinol?

    I also am dealing with some very sore elbows, remnants of an attack that started over four weeks ago.  I am so sick of this crap!  Eat healthy, don’t drink alcohol, take my Alopurinol religiously every morning and this is how I’m rewarded?

    I also had some fluid drained from a very sore knee last week.  For shits and giggles, the doctor is going to test the fluid for uric acid crystals.  He thinks that gout has helped destroy my knee and the cartilage within it.  I also have a partially torn meniscus, but some of the other pain I’m feeling in the knee isn’t related to that.

    Fun times, fun times indeed……… I have a camping/hiking trip planned in Chamonix, France this weekend.  Looks like I’ll be doing more sitting on my ass than anything.

    Sorry, I just needed to vent.

    Allopurinol Causes Gout Flare in Little Toe

    When you start to lower uric acid, old crystals can dissolve partially and cause a gout attack. For more facts see Allopurinol Medication: Why It Hurts To Get Rid Of Gout.

    To prepare for this, I recommend you start a GoutPal Plan for Gout Patients.


    This is as good a place as any to vent.

    It is unfortunate, but your joints will be packed with uric acid crystals, and as these dissolve, they can bring about the type of gout flare you are experiencing. See Allopurinol Medication: The Gout Cure That Can Hurt.

    The only good news is that the attacks will get less intense and less frequent, as long as you keep your urc acid level below 6. The only way to speed up this process is to increase the allopurinol to make the uric acid crystals dissolve faster.

    Hang in there – it will get better.


    It felt soooo good to get home from work and take my damn shoes off! 

    Thanks for the reply GoutPal.  I knew there would be some joint discomfort while getting rid of the built-up uric acid crystals in my joints, but I wasn't expecting this.  I think this is going to ruin a rare three-day weekend for me.  It's unbelievable how much one little toe can hurt.  Not that the people on this forum don't already know this……  And to think, this is a 'minor' attack. 


    Sounds (and looks) like you need a day of Colchicine (Zips method) to clear that up.  Then you might be able to go on your trip. Did you have any warnings that this toe was starting to flare up?


    It's been a while since I've posted, but I thought I would update everyone on the latest. 

    I finally got a positive diagnosis stating that I am suffering from gout six weeks ago.  After six knee drains, taken at various times during differing acute attacks over the past few months,  crystals were detected in the fluid sample.  The first five drainings took place at my local orthopedists office.  The fluid samples were being sent off to Nurnberg for analysis.  The last draining took place at a clinic that had an on-site lab.  I was told by the specialist on this last occassion that the samples are very fragile and can be easily damaged when shipped.  If anyone else is having problems getting a confirmed diagnosis when it's obvious gout is the problem, check to make sure that the lab tests are being done on-site. 

    Anyway, I'm getting my uric levels checked every two weeks.  Every time they are between 4 and 6.  My allopurinol dosage was bumped up to 600mg/day 6 weeks ago from the 300mg/day I was taking.  Still, I am suffering through horrendous attacks.  I have now been taking 300+ mg/day of allopurinol for over 4 months, I have cut all meat and alcohol out of my diet for the last 8 weeks and I'm still suffering.  These aren't just attacks targeting one big toe at a time either.  I'm having mulitple joints attacked at the same time and the pain at times is absolutely excruciating. 

    I have spent the last three weeks on leave-without-pay (disability pending) to try and rest.  Things were going okay for the first three weeks – a twinger here, a twinge there but nothing serious.  Two days ago, however, I woke up with a fully inflamed toe on my right foot and a badly swollen and red ankle on my left.  Now my knee has jumped on the bandwagon and is killing me.  I'm f'ing miserable.

    I know there is no sure-fire cure and nobody can really say anything to help.  Just thought I'd share.

    I have also been working on a book the past three weeks detailing my bouts with various injuries and gout over the past 15 years.  It has actually been quite therapeutic to write it all down.  For those of us that have been suffering from this malady for a while, we know that gout just doesn't cause physical pain.  It's also extremely mentally draining, affecting all facets of life.  I have no idea what I'll do with the manuscript when I'm done, but at least it has helped and made me realize just how much gout has affected my life the past decade and a half.

    I hope everyone's Christmas was good (Santa brought me a gout attack…).  Have a happy new year – and stay away from the grog!


    Many of us were welcomed by Santa with an attack. Ho ho ho and thanks a lot you big fat bearded bastard.

    Hang in there Nate your on the right path.

    Richard Bell

    Hang in there, NateA. I’ve been under attack in the feet, ankles, knees, elbows, wrists and hands for the past five months. I’m taking Uloric to lower SUA and I’m finally down to 4.4 and finally in the last two weeks am walking without a cane. Makes me almost envy the folks who only get attacks in the big toe.:lol:


    Thanks guys.

    I DO envy those that only get attacks in the big toe!  Those were the salad days, man.  I just hope those that are starting to battle with this affliction are able to nip it in the bud using the advice they find here.  Be proactive, not reactive.  Where was this knowledge fifteen years ago??

    It seems lately that my knees and Achilles area have been a favorite spot for the attacks to happen.  Right now, though, I’ve got it in a brand-new place – it’s not in the knee joint per se, but I have a tremendous amount of pain just below my knee, where the little bump is on the front of the leg.  It’s actually not as bad as having it in the knee.  At least I can somewhat bend my leg.  It really doesn’t matter, though.  My damn foot is so swollen right now that I can barely walk anyway.  These are the times when I could use a beer or twenty………..



    That’s called “jumper’s knee” an inflamed patellar tendon. Some people get relief by putting a tight band around just below the kneecap. That should help no matter what the cause of the inflammation.

    Might be worth a try.

    (Somebody tried to convince me that I had it but mine was an inflamed quadriceps tendon…ABOVE the kneecap. It hurt for months and stopped when I gave up the elliptical trainer for several weeks.)


    zip – it's not jumper's knee.  I'm quite familiar with that ailment!  After a couple of days, the pain did move up in to my knee joint proper.  This was obviously gout pain too.  It was very odd.  My orthopedist has mentioned on a few ocassions that uric acid crystals can be deposited in what he calls soft joint tissue and I think this was the case here. 

    I did have an MRI on the knee last January and I did have a small tear in my patellar tendon.  It seems that the gout likes to manifest itself in a lot of locations where I've had previous injuries in the past.  Probably the case here.  It was just a new area for an attack and it took me by surprise I guess.


    Reading a couple of Nate's Posts, it would be a fair assumption that joint damage from accident or abuse would be a major contributing factor in allowing the crystals to find a home. I have made the same personal observation, where I am attacked in joints I have damaged.

    My little toe which is currently around 30/50% larger than normal with the tophi, but when the imflamation and the lump  reduce ,I am left with a toe with a joint that moves around a lot so that I can't walk in bare feet as the toe won't go where it is supposed too,this is no doubt due to a build up and UA damage to the joint over many years. So in some ways it is more comfortable swollen and in other ways it just hurts.

    Give the Epsom Salts bath a go for your foot, it certainly helps me. Repeat it as necessary.

    Hang in there.


    The gout/injury relationships can be hard to work out.

    On the one hand, gout attacks can be induced by trauma – presumably resulting from blood flow restrictions at the injury site.

    On the other hand, urate crystals weaken tendons, cartilage and bone – that weakness can raise the risk of injury if joints are stressed.

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